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Should Breast Implant Placement Be Changed During Replacement?

asked 3 years ago by cheeka Rae in sacramento ca
Latest answer by Sutton Graham II, MD
Question viewed 883 times
Tags: breasts

I need to replace my old silicone breast implants (24 years old). They are currently on top of the muscle. Should they be replaced over the muscle or in the same spot?

8 answers to Should Breast Implant Placement Be Changed During Replacement?

Replacement; yes. Repositioning; maybe. Surgeon consult; yes.

Cheeka rae: The deflation rate of 24 year-old gel implants is high enough that you are right to consider replacement. If not, MRI may be used to confirm that they're intact. Repositioning is a question that is difficult to answer without exam and more information. I do recommend complete capsule removal when silicone gel implants are leaking. I generally recommend subpectoral placement when doing new augmentation, but not always when doing replacement if a patient is satisfied with their... more

Sutton Graham II, MD
Greenville Plastic Surgeon

If the breasts are hard, then the answer is yes. If you...

If the breasts are hard, then the answer is yes. If you have a strong family history of breast cancer or have one of the BRAC genes, then I would advise you to have them placed behind the muscle. Otherwise, keep them over the muscle; the recovery will be a bit easier.

Manuel M. Pena, MD
Naples Plastic Surgeon

In general, I prefer under the muscle

The phrasing of your question is a bit confusing. I prefer having implants under the muscle in almost all cases. Therefore if the implant is above the muscle I usually convert it to below the muscle. If the implant is below the muscle then I prefer to leave it there. I believe that below the muscle leaves a better aesthetic result and leads to less capsule contracture. Wishing you all the best.

Talmage J. Raine, MD
Chicago Plastic Surgeon

Implant location probably should not be changed.

Hi! Remember, I have not examined you. I would usually leave the new implants over the muscle. After 24 years, there is often a little sagging that is best corrected with the implants over the muscle. If you have no sagging and very thin tissues, then I would consider putting them under the muscle. Changing the location of the implants is more surgery, and with more surgery there can be a little more risk. So that's something else to consider. In either location, you will need a... more

George J. Beraka, MD
Manhattan Plastic Surgeon

It depends on your exam

I commonly perform a site change operation when I remove old implants that have been placed over the muscle in the past. The main reason is to provide an improved appearance of the upper breasts due to the thinness of the tissue. It does not always mean that you will need to have a lift at the same time but it is possible if your tissues have stretched. Best of luck. Dr. Edwards

Michael C. Edwards, MD
Las Vegas Plastic Surgeon

www.medwardsmd.com

Maybe

If you move the inplants to the under the muscle location, it may create the need for a lift. If you have had no problems with them over the muscle and you liked the shape, you might just want to leave them over. sek

Scott E. Kasden, MD
Dallas Plastic Surgeon

There is no need to change the location of the breast implants in your case

While it is a good idea to change out these older silicone gel breast implants, unless there is a problem with capsular contraction there is no need to put them under the muscle. It is however important to remove the scar capsule around the implant to avoid leaving any silicone that may have leaked or may be out side because the implant has ruptured. if the reason for replacing the implants is that you have developed a sever capsular contraction with an intact implant which is not... more

Carl W. "Rick" Lentz III, MD
Daytona Beach Plastic Surgeon

Advantages and disadvantages of implant position

There are advantages and disadvantages to the subglandular and submuscular position for implants. These include so-called "safety" issues like capsular contractures, ability to get adequate mammograms, potential impact on the surrounding breast gland should you develop an infection or silicone leak, and potential soft tissue atrophy. But there are also cosmetic issues such as softness to the touch, naturalness in movement, visibility of rippling, excessive roundness, and degree of... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

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